Pub Date : 2021-10-26DOI: 10.26420/austinjmusculoskeletdisord.2021.1060
Urso R, M. L, O. A, M. A., Berti M, P. R., Tigani D
Cephalomedullary nailing is considered the treatment of choice for trochanteric and subtrochanteric femoral fractures. The aim of this study was to report postoperative outcomes of one of the widely used trochanteric nail device, the Gamma 3 long nail. We retrospectively assessed 405 patients treated with Gamma 3 long nail in a single Level One Trauma Centre between 2010 and 2018. We finally included 261 ambulant patients with 65 years or older, a lowenergy trauma and a closed trochanteric or subtrochanteric femoral fracture. Clinical outcomes were evaluated using the Hip Fracture Functional Recovery Score (FRS), while radiological complications and failures were assessed on postoperative x-rays. More than two-thirds of patients had completed fracture consolidation within 4 months after surgery. Immediate full weight bearing was allowed postoperatively in 64.0% of patients. We reported a mortality of 24.5% at one year postoperatively. The leading clinical postoperative complication was anemia (69.3%), followed by deep venous thrombosis (7.7%). Coxa vara was observed in 73 patients (28%), followed by malreduction in flexion-external rotation of the proximal femoral fragment (26.8%). No case of lag screw cutout was reported. Our study indicated that last generation of Long Gamma nail is a reliable implant for trochanteric and subtrochanteric femoral fractures in the elderly patients, leading to high rate of bone union and reduced incidence of related complications. An excellent fracture reduction and prevention of postoperative varus malalignment are the main factors that can avoid the major postoperative complications and failures after Gamma 3 long nailing.
{"title":"Gamma 3 Long Nail for Complex Sub-Trochanteric Fractures: A Ten-Year Retrospective Study","authors":"Urso R, M. L, O. A, M. A., Berti M, P. R., Tigani D","doi":"10.26420/austinjmusculoskeletdisord.2021.1060","DOIUrl":"https://doi.org/10.26420/austinjmusculoskeletdisord.2021.1060","url":null,"abstract":"Cephalomedullary nailing is considered the treatment of choice for trochanteric and subtrochanteric femoral fractures. The aim of this study was to report postoperative outcomes of one of the widely used trochanteric nail device, the Gamma 3 long nail. We retrospectively assessed 405 patients treated with Gamma 3 long nail in a single Level One Trauma Centre between 2010 and 2018. We finally included 261 ambulant patients with 65 years or older, a lowenergy trauma and a closed trochanteric or subtrochanteric femoral fracture. Clinical outcomes were evaluated using the Hip Fracture Functional Recovery Score (FRS), while radiological complications and failures were assessed on postoperative x-rays. More than two-thirds of patients had completed fracture consolidation within 4 months after surgery. Immediate full weight bearing was allowed postoperatively in 64.0% of patients. We reported a mortality of 24.5% at one year postoperatively. The leading clinical postoperative complication was anemia (69.3%), followed by deep venous thrombosis (7.7%). Coxa vara was observed in 73 patients (28%), followed by malreduction in flexion-external rotation of the proximal femoral fragment (26.8%). No case of lag screw cutout was reported. Our study indicated that last generation of Long Gamma nail is a reliable implant for trochanteric and subtrochanteric femoral fractures in the elderly patients, leading to high rate of bone union and reduced incidence of related complications. An excellent fracture reduction and prevention of postoperative varus malalignment are the main factors that can avoid the major postoperative complications and failures after Gamma 3 long nailing.","PeriodicalId":114171,"journal":{"name":"Austin Journal of Musculoskeletal Disorders","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127935121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-20DOI: 10.26420/austinjmusculoskeletdisord.2021.1059
M. L, Wang S
Purpose: For several years, adipose tissue has gained increasing interest as an ideal source of mesenchymal stem cells for the regenerative treatment of numerous pathologies and degenerative processes, as like Knee Osteoarthritis (KOA). The aim of our study was to report postoperative clinical, functional and radiological outcomes in patients with KOA treated with intra-articular injection of autologous Adipose-Derived Stem Cells (ADSCs). Methods: We performed a systematic review searching for all the clinical studies dealing with the use of ADSCs for the treatment of KOA published in PubMed and Embase until April 2021. We included 8 prospective studies dealing with postoperative outcomes after ADSCs therapy. Results: All clinical and functional outcomes improved after intra-articular injections of ADSCs. Postoperative magnetic resonance imaging (MRI) scores showed an increased quality of repaired cartilage compared to the preoperative time. No serious advent events were observed. Conclusion: This study suggests that ADSCs therapy seems to be safe and effective. It can be considered an innovative procedure for improved cartilage regeneration and as adjuvant for the surgical treatment of diffuse degenerative chondral lesions with good clinical and radiological outcomes.
{"title":"Adipose-Derived Mesenchymal Stem Cells for the Treatment of Knee Osteoarthritis: A Systematic Review","authors":"M. L, Wang S","doi":"10.26420/austinjmusculoskeletdisord.2021.1059","DOIUrl":"https://doi.org/10.26420/austinjmusculoskeletdisord.2021.1059","url":null,"abstract":"Purpose: For several years, adipose tissue has gained increasing interest as an ideal source of mesenchymal stem cells for the regenerative treatment of numerous pathologies and degenerative processes, as like Knee Osteoarthritis (KOA). The aim of our study was to report postoperative clinical, functional and radiological outcomes in patients with KOA treated with intra-articular injection of autologous Adipose-Derived Stem Cells (ADSCs). Methods: We performed a systematic review searching for all the clinical studies dealing with the use of ADSCs for the treatment of KOA published in PubMed and Embase until April 2021. We included 8 prospective studies dealing with postoperative outcomes after ADSCs therapy. Results: All clinical and functional outcomes improved after intra-articular injections of ADSCs. Postoperative magnetic resonance imaging (MRI) scores showed an increased quality of repaired cartilage compared to the preoperative time. No serious advent events were observed. Conclusion: This study suggests that ADSCs therapy seems to be safe and effective. It can be considered an innovative procedure for improved cartilage regeneration and as adjuvant for the surgical treatment of diffuse degenerative chondral lesions with good clinical and radiological outcomes.","PeriodicalId":114171,"journal":{"name":"Austin Journal of Musculoskeletal Disorders","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121110666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-07DOI: 10.26420/austinjmusculoskeletdisord.2021.1058
Fatyga P, Wizner B, Fedyk-Łukasik M, Grodzicki T, S. A.
Background: Malnutrition and poor physical performance are associated with higher morbidity, mortality, and lower quality of life. Muscle and fat mass have been shown to be related to nutritional status and physical fitness. Objectives: The aim of this study was to assess the relationship between nutritional status, body composition and physical performance in outpatient older adults. Materials and Methods: Demographic data and medical history were collected from patients aged ≥60 years followed in the Geriatric Outpatient Clinic using a structured questionnaire. Body Mass Index (kg/m²) was calculated. Body composition was measured by dual-energy X-ray absorptiometry. Physical performance was assessed by handgrip Strength (HGS), Gait Speed (GS), Timed Up & Go Test (TUG), Six Minute Walk Test (6MWT), nutritional status by Mini Nutritional Assessment (MNA) and serum albumin level. Results: Mean age of 76 patients (64.47% men) was 71.93±8.88 yrs. In multiple regression analyses, age, good nutritional status and percent of lower extremity fat, but not appendicular Lean Mass (aLM), independently influenced gait speed; in turn longer TUG time was associated with poorer nutritional status, older age and a higher number of medical comorbidities. Higher handgrip strength was related to male sex, greater aLM, and younger age, and 6MWT was influenced negatively by age and percent of lower extremity fat. Conclusions: Age and nutritional status remain a strong determinant of physical fitness deterioration. Identifying the relationship between deficits in physical performance, nutritional status and body composition can help elucidate the causes of disability and target preventive measures.
{"title":"How Nutritional Status and Body Composition Affect Physical Performance of Older Adults?","authors":"Fatyga P, Wizner B, Fedyk-Łukasik M, Grodzicki T, S. A.","doi":"10.26420/austinjmusculoskeletdisord.2021.1058","DOIUrl":"https://doi.org/10.26420/austinjmusculoskeletdisord.2021.1058","url":null,"abstract":"Background: Malnutrition and poor physical performance are associated with higher morbidity, mortality, and lower quality of life. Muscle and fat mass have been shown to be related to nutritional status and physical fitness. Objectives: The aim of this study was to assess the relationship between nutritional status, body composition and physical performance in outpatient older adults. Materials and Methods: Demographic data and medical history were collected from patients aged ≥60 years followed in the Geriatric Outpatient Clinic using a structured questionnaire. Body Mass Index (kg/m²) was calculated. Body composition was measured by dual-energy X-ray absorptiometry. Physical performance was assessed by handgrip Strength (HGS), Gait Speed (GS), Timed Up & Go Test (TUG), Six Minute Walk Test (6MWT), nutritional status by Mini Nutritional Assessment (MNA) and serum albumin level. Results: Mean age of 76 patients (64.47% men) was 71.93±8.88 yrs. In multiple regression analyses, age, good nutritional status and percent of lower extremity fat, but not appendicular Lean Mass (aLM), independently influenced gait speed; in turn longer TUG time was associated with poorer nutritional status, older age and a higher number of medical comorbidities. Higher handgrip strength was related to male sex, greater aLM, and younger age, and 6MWT was influenced negatively by age and percent of lower extremity fat. Conclusions: Age and nutritional status remain a strong determinant of physical fitness deterioration. Identifying the relationship between deficits in physical performance, nutritional status and body composition can help elucidate the causes of disability and target preventive measures.","PeriodicalId":114171,"journal":{"name":"Austin Journal of Musculoskeletal Disorders","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126432822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-10DOI: 10.26420/austinjmusculoskeletdisord.2021.1057
Hervik J, Stub T
Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is defined as chronic pelvic pain lasting for at least 3 months, often associated with lower urinary tract symptoms and/or sexual dysfunction [1]. Prostatitis is a common condition, with 35–50% of men affected by symptoms suggesting prostatitis during their lifetime. It is associated with negative psychological effects and substantial health care costs [2]. There are currently many approaches for its management, using both pharmacological and non‐pharmacological interventions, though there is a lack of evidence for the efficacy of these treatments. A systematic review [3] examined the evidence for 16 different pharmacological treatments of CP/CPPS. Ninety-nine studies included 9119 men. Treatment approaches included alpha-blockers, 5-alpha reductase inhibitors, antibiotics, anti-inflammatories, allopurinol and botulinum toxin injections. The authors found low‐ to very low‐quality evidence that these interventions cause a reduction in prostatitis symptoms, without an increased incidence of adverse events in the short term. They reported lack of evidence regarding the effects of these drugs on sexual dysfunction, quality of life, or anxiety and depression. The efficacy of acupuncture on CP/CPPS was examined in a systematic review and meta-analysis [4] of 10 published trials (n=770). Analysis revealed that acupuncture significantly reduced the National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) score and provided pain relief, compared to standard medication, and reduced symptoms when compared to sham. Four acupuncture sessions were the minimum “dose” to reach clinical efficacy, and prolonged acupuncture sessions continuously improved urinary symptoms and quality of life. Peripheral Nerve Stimulation (PNS) is an effective tool for the treatment of chronic pain. Miniaturized devices that are less invasive than previous generations has brought this treatment modality into mainstream use. Recent clinical evidence suggests clinically significant and sustained reductions in pain can persist well beyond the PNS treatment period [5]. Acupuncture is a minimally invasive method of PNS. Acupuncture points have been shown to overlie major neuronal bundles, which correlate with cutaneous branches of major nerves [6]. These nerves converge and interact with visceral nociceptive inputs at the spinal cord level. This anatomical correlation provides the basis on which acupuncture applied to a specific region could treat a variety of conditions such as prostatitis, remote to the site of treatment.
{"title":"Acupuncture Used as a Method of Peripheral Nerve Stimulation in Chronic Prostatitis: A Case Study","authors":"Hervik J, Stub T","doi":"10.26420/austinjmusculoskeletdisord.2021.1057","DOIUrl":"https://doi.org/10.26420/austinjmusculoskeletdisord.2021.1057","url":null,"abstract":"Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is defined as chronic pelvic pain lasting for at least 3 months, often associated with lower urinary tract symptoms and/or sexual dysfunction [1]. Prostatitis is a common condition, with 35–50% of men affected by symptoms suggesting prostatitis during their lifetime. It is associated with negative psychological effects and substantial health care costs [2]. There are currently many approaches for its management, using both pharmacological and non‐pharmacological interventions, though there is a lack of evidence for the efficacy of these treatments. A systematic review [3] examined the evidence for 16 different pharmacological treatments of CP/CPPS. Ninety-nine studies included 9119 men. Treatment approaches included alpha-blockers, 5-alpha reductase inhibitors, antibiotics, anti-inflammatories, allopurinol and botulinum toxin injections. The authors found low‐ to very low‐quality evidence that these interventions cause a reduction in prostatitis symptoms, without an increased incidence of adverse events in the short term. They reported lack of evidence regarding the effects of these drugs on sexual dysfunction, quality of life, or anxiety and depression. The efficacy of acupuncture on CP/CPPS was examined in a systematic review and meta-analysis [4] of 10 published trials (n=770). Analysis revealed that acupuncture significantly reduced the National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) score and provided pain relief, compared to standard medication, and reduced symptoms when compared to sham. Four acupuncture sessions were the minimum “dose” to reach clinical efficacy, and prolonged acupuncture sessions continuously improved urinary symptoms and quality of life. Peripheral Nerve Stimulation (PNS) is an effective tool for the treatment of chronic pain. Miniaturized devices that are less invasive than previous generations has brought this treatment modality into mainstream use. Recent clinical evidence suggests clinically significant and sustained reductions in pain can persist well beyond the PNS treatment period [5]. Acupuncture is a minimally invasive method of PNS. Acupuncture points have been shown to overlie major neuronal bundles, which correlate with cutaneous branches of major nerves [6]. These nerves converge and interact with visceral nociceptive inputs at the spinal cord level. This anatomical correlation provides the basis on which acupuncture applied to a specific region could treat a variety of conditions such as prostatitis, remote to the site of treatment.","PeriodicalId":114171,"journal":{"name":"Austin Journal of Musculoskeletal Disorders","volume":"110 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121852760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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